Association between adverse childhood experiences and long-term blood pressure variability: Insights from a pooled analysis

Background: The association between adverse childhood experiences (ACEs) and long-term blood pressure variability (BPV) remains unexamined. This study aimed to identify the longitudinal association between ACEs and BPV, and explore the potential modification effect by using a pooled analysis. Methods: Participants with complete information from the Health and Retirement Study (HRS), the English Longitudinal Study of Ageing (ELSA), and the China Health and Retirement Longitudinal Study (CHARLS) were included. A score of ACEs was summed by questionnaires, and the standard deviation (SD) was calculated to assess the BPV in main analyses. A linear regression model was performed to explore the association between ACEs and BPV. Pooled effects were determined through random-effects meta-analysis, with Cochran's Q test value and I² statistic reported to assess heterogeneity. Results: The study included 6187, 2654, and 2929 eligible participants from the HRS, the ELSA, and the CHARLS, respectively. After adjusting for covariates, ACEs were significantly associated with higher SD of systolic blood pressure (BP) (pooled β: 0.131, [95%CI: 0.029, 0.233]), and associated with higher SD of diastolic BP (pooled β: 0.092, [95%CI: −0.016, 0.200]). A pooled analysis showed that the association between ACEs and BPV was more pronounced among hypertensive participants, especially in systolic BP (pooled β: 0.189, [95%CI: 0.035, 0.342]. Conclusion: We for the first time reported that ACEs were significantly associated with higher long-term BPV, and hypertension status played a role in this relationship. More early intervention and support should be provided to the population with ACEs, especially for those with hypertension.